EP0668749B1 - Spine osteosynthesis instrumentation for an anterior approach - Google Patents

Spine osteosynthesis instrumentation for an anterior approach Download PDF

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Publication number
EP0668749B1
EP0668749B1 EP94901415A EP94901415A EP0668749B1 EP 0668749 B1 EP0668749 B1 EP 0668749B1 EP 94901415 A EP94901415 A EP 94901415A EP 94901415 A EP94901415 A EP 94901415A EP 0668749 B1 EP0668749 B1 EP 0668749B1
Authority
EP
European Patent Office
Prior art keywords
rods
blocks
instrumentation according
slide
instrumentation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP94901415A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP0668749A1 (en
EP0668749A4 (en
Inventor
Christoph Hopf
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Societe de Fabrication de Material Orthopedique en Abrege SOFAMOR SNC
Original Assignee
Societe de Fabrication de Material Orthopedique en Abrege SOFAMOR SNC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Societe de Fabrication de Material Orthopedique en Abrege SOFAMOR SNC filed Critical Societe de Fabrication de Material Orthopedique en Abrege SOFAMOR SNC
Publication of EP0668749A1 publication Critical patent/EP0668749A1/en
Publication of EP0668749A4 publication Critical patent/EP0668749A4/en
Application granted granted Critical
Publication of EP0668749B1 publication Critical patent/EP0668749B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7044—Screws or hooks combined with longitudinal elements which do not contact vertebrae also having plates, staples or washers bearing on the vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Definitions

  • the present invention relates to a spinal osteosynthesis instrumentation for an anterior approach.
  • the approach on the left side of the vertebral column is preferred despite the proximity of the aorta, owing to the presence on the right side of the vena cava which is more fragile and less easy to move than the aorta.
  • U.S. patent 4,289,123 proposes an orthopedic appliance for use in an anterior approach. It describes the use of rocker arm brackets for attachment to the vertebra, with a pair of rocker arm brackets being joined across a damaged or diseased vertebra by a pair of threaded rods. However, with this system the connecting rods must be installed before attachment of the brackets to the vertebra, making installation of the appliance difficult.
  • an object of the invention is to provide an instrumentation which permits overcoming these shortcomings and therefore treating, indifferently in a completely satisfactory manner, fractures and tumours as well as spinal deviations.
  • the invention provides an instrumentation spinal osteosynthesis instrumentation for an anterior approach, said instrumentation comprising in combination: two rigid rods at least two blocks for transversely interconnecting said blocks defining openings for respectively receiving one of said rods therein rods in such manner that said rods are axially slidable and revolvable about themselves in said blocks, means for clamping said rods against rotation and translation in said blocks and bone anchorage elements combined with said blocks, characterised in that said means for clamping said rods are slidably disposed within said blocks and bear against said rods.
  • Two blocks and the two associated rods thus make up a rectangular frame affording all of the required stability for restoring the axial continuity of the vertebral column, avoiding correction losses, and facilitating the consolidation of the bone graft.
  • each block has in a transverse direction, from an anterior part toward a posterior part of the vertebral bodies, a generally curved shape corresponding to the antero-lateral anatomy of the vertebral bodies, the anterior surface intended to be applied on a vertebral body being therefore concave while the exterior surface is convex.
  • the spinal osteosynthesis instrumentation for an anterior approach shown in Figs. 1 to 7 comprises at least two blocks 1 adapted to transversely interconnect two rigid rods 2, 3 which are parallel to each other and axially slidable in said blocks.
  • the instrumentation is shown in the vertical position viewed on the left side of the spine.
  • the blocks 1 are provided with means for clamping the rods 2, 3 against rotation and translation and comprising essentially, for each block 1, two slides 4, 5 movable in translation in a direction parallel to the rods 2, 3 in corresponding recesses 6, 7 provided in the blocks 1.
  • Each block 1 is also provided with a pair of bone anchorage screws 8, 10 which may be placed in position by inserting them in corresponding bores 9, 11 provided in the bottom of the recesses 6 and 7.
  • the bores 9, 11, and therefore the screws 8, 10, have suitable inclinations so that the two screws converge at a suitable angle, preferably on the order of 25°.
  • the screws 8, 10 have a conical head the taper of which corresponds to that of the bores 9, 11 so that, when they are placed in the bottom of the recesses 6, 7 or in the bottom of semi-cylindrical channels receiving the rods 2 and 3, they do not project and are blocked in axial abutment by the presence of the rod.
  • Cavities 55 provided in the surface of each recess facilitate the supporting of a boring tool (not shown) providing a prior bore for the bore 9, 11.
  • Each block 1 has, in the transverse direction from the anterior part toward the posterior part of the vertebral bodies on which they must be anchored by means of the screws 8, 10, a generally curved shape shown in particular in Figs. 5 to 7 and corresponding to the antero-lateral anatomy of the vertebral bodies.
  • this outer surface has a substantially convex shape from the anterior surface S1 to the posterior surface S2, while the interior surface S3, adapted to be applied against the vertebral body, is concave.
  • Each block 1 has a substantially rectangular general shape of which the anterior region has a thickness less than that of the posterior region and the edges 12, 12a are rounded.
  • the radius of curvature of the anterior surface S1 is distinctly less than that of the posterior surface S2.
  • each block is smooth owing to the fact that the surface of the slides 4, 5 are flush with the surrounding surface of the block, thereby avoiding any projection.
  • the two recesses 6 and 7 extend in a direction parallel to each other and are each adapted to receive a portion of the respective rod 2, 3: the posterior rod 2 has a diameter distinctly larger than that of the rod 3 for a reason which will be explained hereinafter. The whole of the device must be disposed in most cases on the left side of the spine with the rod 2 in the posterior position.
  • each recess 6, 7 Arranged in the bottom of each recess 6, 7 is a semi-cylindrical channel 13, 14 whose diameter corresponds to that of the respective rod 2, 3. Further, two lateral grooves 15a, 16a and 15b, 16b are formed in the sides of each recess 6, 7 in parallel relationship. These lateral grooves are adapted to receive corresponding lateral flanges 17, 18, 19, 20 of the respective slides 4 and 5. The flanges 17, 18, on one hand, and 19, 20, on the other, are arranged in a substantially different manner, as can be seen in Figs. 5 to 7, owing to the dissymmetry between the posterior and anterior parts of each block 1. Consequently, the same is true of their corresponding grooves (15a, 16a, 15b, 16b).
  • the flanges 17, 18 and 19, 20 are inclined at a suitable angle A (Fig. 2) on the bottom of the recesses 6, 7 in the same way as their respective lateral grooves 15a...16b which have for this purpose ramps of the same inclination A as the flanges 17...20.
  • the inclinations of the flanges (17...20) are inverted on the slides 4 and 5 so that the latter are inserted in the recesses 6, 7 in opposite directions indicated by the arrows (Figs. 1 and 4) to obtain a technical result which will be explained hereinafter.
  • the angle of inclination A of the flanges 17, 18 and 19, 20 and of the ramps may be between about 2 and 6°.
  • the entry ends of the flanges (19...20) are advantageously machined in such manner as to have chamfers or rounded edges, such as 17a (Fig. 2).
  • the entry edges of the recesses 6, 7 also have chamfers not, shown in Figs. 1 to 7 but shown in Figs. 8 to 12 (50, 51).
  • these chamfers facilitate the insertion of the slides 4, 5 in their recesses 6, 7.
  • Each block 1 can include complementary clamping means for each slide 4, 5.
  • these clamping means comprise, for each slide 4, 5, a respective screw 23, 24 which can be inserted in an opening 25, 26 provided in the central part of the block 1 between the recesses 6, 7.
  • the opening 25 for the screw 23 communicates through a lateral passage 27 (Fig. 5) with the adjacent groove 16b of the lateral flange 19 of the slide 5.
  • the opening 27 of the passage between the opening 26 for the screw 24 and the groove 16a of the flange 18 of the slide 4 is shown in Fig. 5.
  • Each screw 23, 24 has, from one end to the other, a screw threaded bone anchorage stem 28, a conical portion 29 which tapers toward the screw threaded stem 28, a fracture cone 31 which tapers toward the conical portion 29, and lastly a screwing head 32.
  • the end of the screw threaded portion 28 is rounded and is substantially flush with the interior surface S3 of the block 1.
  • This screw threaded portion 28 is so dimensioned, as is the conical portion 29, that the latter bears against the adjacent flange 18, 19 of the respective slide 4, 5 by extending through the opening of the passage 27 (Figs. 5 and 6).
  • An aperture 34 is provided in the anterior part of each block in the surface S1 between the recess 7 and the rounded edge 12. This aperture 34 is adapted to receive the rounded head 35 of a distraction-compression tool 36 (Fig. 13) which is known per se and does not require description.
  • the posterior rod 2 may have a diameter of 4 to 7 mm while the anterior rod 3 has a smaller diameter of 3 to 6 mm. This difference between the diameters is explained by the fact that it is on the posterior rod 2 that the main forces are exerted, in particular those due to derotation. On the other hand, the anterior rod 3 is subjected to smaller mechanical forces and may consequently have a smaller diameter. Further, this anterior rod 3 is the closest to the large blood vessels so that its reduced diameter increases the surgical safety of the instrumentation. However, this difference in diameter is not obligatory and the two rods 2 and 3 may possibly have the same diameter.
  • Fig. 14 shows an embodiment of the instrumentation according to the invention constituting a short arrangement extending along a vertebral segment of three vertebrae L3, L2, L1.
  • the sequence of the mounting of the component parts of this instrumentation is the following:
  • a posterior rod 2 for example having a diameter of 6 mm, is placed in the posterior recesses 6 in the upper block and lower block.
  • the posterior slides 4 corresponding to the recesses 6 are installed on their respective inclined ramps 6a, 7a and are placed in contact with the upper side of the rod 2.
  • This rod is thus trapped in the recesses 6 of the blocks but remains movable in translation and rotation under the action of outside forces. This is why the position of the slides on their clamping ramps, or intermediate position, must be such as to permit acting in complete safety on the rod without allowing the latter to escape from its recess.
  • the slides are consequently not pushed to the end of their inclined ramps.
  • Such an intermediate position of the slides enables the surgeon to effect if necessary a derotation action on the vertebral column by revolving the posterior rod 2 about itself.
  • Corresponding to this derotation is a new position of the rod 2 relative to the connecting recesses 6, this position being automatically obtained in accordance with the nature of the change brought about in the vertebral column by the derotation effect.
  • an anterior rod 3 for example having a diameter of 4 mm, of the same length as the posterior rod 2 in the embodiment shown in Fig. 14 (no slides are shown), is inserted in the anterior recesses 7 of the upper block and lower block.
  • the anterior slides 5 are placed on their respective inclined ramps in such manner as to maintain the rod 3 in a trapped position but sufficiently free to move in particular in translation. Their gripping action round the rod is therefore not complete as they are not pushed to the end of their inclined ramps.
  • an intervention involving distraction or compression of the vertebrae relative to one another may be performed by the surgeon by means of the ancillary device 36 or a like ancillary device the studs 35 of which are inserted in the bores 34 located in the anterior parts of the two blocks.
  • the anchorage screws 8, 10 are indeed intentionally placed at the bottom of the recesses and advantageously possess a conical head (Figs. 5 and 6) corresponding to the taper of the bores 9, 11 so that the head does not assume a projecting position in the semi-cylindrical channels 13, 14 receiving the rods 2, 3.
  • the anchorage screws 8, 10 are also clamped and can in no way, under the multiple effects of the movements of the body of the patient, become detached from the vertebral column in which they are inserted. Their axial displacement is rendered impossible so that, in the event of a possible fracture in any region of its length, the two screw portions are held fast and nonetheless maintain the block.
  • the rectangular structure obtained by the assembly of two clip-blocks 1 with their slides 4, 5 and the two rods 2, 3, constitutes a device for the fixation and the rectangulation of the assembly providing an improved stabilization.
  • the rectangulation of the device is automatically obtained by the mounting of the anterior consolidation rod 3.
  • this thickness should not exceed 11 mm in the posterior third of the vertebral body and 9 mm in the middle third. This avoids any interference with the consolidation of the bone graft.
  • each clip-block 1 is completely smooth, in particular in its most rounded lateral part S1 corresponding to the anterior positioning on the vertebrae.
  • the upper surface of the slides 4, 5 which is also smooth is flush with the surfaces S1, S2 of the lateral parts and of the central part of the block 1, so that no particular element projects. This is a notable advantage of the clip-block provided by the invention.
  • each screw 23, 24 clamping the slides 4 and 5 afford additional safety to the instrumentation by the tightening of their conical portions 29 on the flanges 18 and 19 of the slides 4, 5. It concerns an additional safety means with respect to the clamping of the slides 4, 5 on the rods C-D 2 and 3, since the clamping is in any case assured by the clamping of the slides on the rods.
  • the screws 23, 24 therefore only have an additional subsidiary effect.
  • each screw 23, 24 is broken off in its upper part after tightening on the block, with the aid of the fracture conical portion 31. This fracture therefore occurs at the junction between the fracture conical portions 31 and the tightening conical portions 29, in the weakest region.
  • each screw 23, 24 is practically hidden in the block 1 since the fracture plane is approximately at a distance of 2 to 3 mm from the surface S2 of the block 1.
  • each block 40 has a generally bent shape so as to have an approximately S-shaped cross-section.
  • the two halves 41 and 42 of the block 40 respectively constitute its posterior and anterior parts, the posterior part 41 having a thickness e1 greater than the thickness e2 of the anterior part 42.
  • the two parts 41, 42 are interconnected by a central part 43 which extends in a general direction P substantially perpendicular to the plane P1 of the bottom of the recess 44 of the-posterior part 41.
  • the general direction P in which the central part 43 extends makes an angle B of less than 90° with the plane P2 of one of the sides of the bottom of the recess 45 of the anterior part 42.
  • semi-cylindrical channels 46, 47 are provided in the bottom of the respective recesses 44, 45 and complementary channels 46a, 47a in the slides 4, 5, the diameters of said channels corresponding to those of the rods 2 and 3.
  • Bores 43, 49 are provided in the bottom of the channels 46, 47 for receiving anchorage screws 10 and 8 respectively.
  • the entry chamfers 50, 51 of the recesses 44 and 45 facilitate the insertion of the corresponding slides 4, 5.
  • the arrangement of the block 40 is similar to that of the block 1, the same reference numerals being used for the corresponding parts in both cases.
  • the anchorage screws 10 and 8 respectively extend through the posterior part 41 and anterior part 42 and make an angle therebetween on the order of 35 to 40°.
  • the anterior part 42 is then placed in a vertebral recess 52 (Fig. 13) produced by the surgeon and opening onto the anterior part of the vertebra, for example L3 or L1.
  • the anterior part 42 of the clip-block 40 is inserted in the vertebral region.
  • the angle between the posterior part 41 and anterior part 42 affords additional safety to the surgeon bearing in mind the proximity of the large vessels in the anterior approach.
  • the edge 12 of the anterior part S1 which is slightly rounded in the transverse direction as already mentioned, may have a radius of curvature of about 15 mm.
  • This specific shape corresponds to the mean estimation of the value of the concavity of the vertebra in the region of the implantation of the block 1, 40 on the latter. This disposition contributes to the obtainment of the desired stability of the whole of the instrumentation owing to the fact that there is in this way an improved distribution of the forces exerted by the concerned faces in contact.
  • the directions of insertion of the slides 4 and 5 are opposite so that over a period of time, when the patient resumes his activity, no loosening of the slides can occur.
  • the forces which tend to loosen the slide or slides 4 clamping the posterior rod 2 can be opposed or balanced by the forces tending to loosen the slide or slides 5 clamping the anterior rod 3.
  • the scope of the invention is not intended to be limited to the two described embodiments since many alternative embodiments may be envisaged.
  • the instrumentation may have the required number of clip-blocks 1, for example three or four.
  • the two rods 2 and 3 be exceptionally different, for example that the posterior rod 2 extend beyond the anterior rod 3.
  • the rods may be fixed as previously described, and the extending portion of the rod may be fixed by at least one clip-block according to the invention but defining a single recess 6 or 7. This block is then fixed so as to maintain the additional length of this rod, the recess for receiving the other rod being unnecessary.
  • the additional means for clamping the slides 4, 5 constituted by the pairs of screws 23, 24 may comprise only a single screw per block 1, which may be inserted in a central aperture in the block. This aperture and the screw then have a diameter which is sufficient to ensure that the aperture communicates through lateral passages with the adjacent grooves (16a, 16b) of the lateral flanges 18, 19 of the slides 4, 5.
  • the screw is provided with a conical portion 29 positioned to engage in said lateral passages and come to bear against the-flanges of the slides so as to reinforce their clamping in their recesses.
  • the aperture 34 may be advantageously eliminated, it being possible to carry out the distraction-compression operation by inserting the head of the ancillary device 36 in the central aperture of the screw.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Steroid Compounds (AREA)
  • Saccharide Compounds (AREA)
  • Measuring Or Testing Involving Enzymes Or Micro-Organisms (AREA)
  • Transplanting Machines (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)
  • Investigating Or Analysing Biological Materials (AREA)
EP94901415A 1992-11-10 1993-11-10 Spine osteosynthesis instrumentation for an anterior approach Expired - Lifetime EP0668749B1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR9213538A FR2697744B1 (fr) 1992-11-10 1992-11-10 Instrumentation d'ostéosynthèse rachidienne par voie antérieure.
FR9213538 1992-11-10
PCT/US1993/010908 WO1994010927A1 (en) 1992-11-10 1993-11-10 Spine osteosynthesis instrumentation for an anterior approach

Publications (3)

Publication Number Publication Date
EP0668749A1 EP0668749A1 (en) 1995-08-30
EP0668749A4 EP0668749A4 (en) 1996-01-03
EP0668749B1 true EP0668749B1 (en) 2002-01-30

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ID=9435416

Family Applications (1)

Application Number Title Priority Date Filing Date
EP94901415A Expired - Lifetime EP0668749B1 (en) 1992-11-10 1993-11-10 Spine osteosynthesis instrumentation for an anterior approach

Country Status (12)

Country Link
EP (1) EP0668749B1 (ko)
JP (1) JP3615757B2 (ko)
KR (1) KR950703897A (ko)
AT (1) ATE212528T1 (ko)
AU (1) AU5601294A (ko)
CA (1) CA2149034A1 (ko)
DE (1) DE69331525T2 (ko)
FI (1) FI952227A0 (ko)
FR (1) FR2697744B1 (ko)
NO (1) NO951827L (ko)
TW (1) TW278029B (ko)
WO (1) WO1994010927A1 (ko)

Families Citing this family (93)

* Cited by examiner, † Cited by third party
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US5615965A (en) * 1992-11-10 1997-04-01 Sofamor S.N.C. Device for interconnecting an elongate element and a support for said element
FR2709247B1 (fr) * 1993-08-27 1995-09-29 Martin Jean Raymond Dispositif d'ancrage d'une instrumentation rachidienne sur une vertèbre.
FR2722393B1 (fr) * 1993-08-27 1996-08-23 Martin Jean Raymond Materiel ancillaire de correction d'une deformation vertebrale
FR2709248B1 (fr) * 1993-08-27 1995-09-29 Martin Jean Raymond Matériel ancillaire de pose d'une instrumentation rachidienne.
FR2709246B1 (fr) * 1993-08-27 1995-09-29 Martin Jean Raymond Orthèse vertébrale implantée dynamique.
DE59507758D1 (de) * 1994-03-10 2000-03-16 Schaefer Micomed Gmbh Osteosynthesevorrichtung
FR2720262B1 (fr) * 1994-05-31 1996-10-18 Pierre Barreau Dispositif d'ostéosynthèse à coapteurs rapportés.
DE69527608T2 (de) * 1994-08-29 2003-02-13 Societe De Fabrication De Materiel Orthopedique Sofamor, Tremblay-En-France Schraubklappe zur befestigung einer osteosynthetischen einrichtung
FR2723837B1 (fr) * 1994-08-29 1997-01-17 Sofamor Danek Group Inc Bouchon filete de serrage pour assurer une liaison entre deux implants d'une instrumentation d'osteosynthese rachidienne ou autres.
US6193719B1 (en) 1995-08-24 2001-02-27 Sofamor S.N.C. Threaded clamping plug for interconnecting two implants of a spinal osteosynthesis instrumentation or other implants
US6004349A (en) 1997-01-06 1999-12-21 Jackson; Roger P. Set screw for use with osteosynthesis apparatus
US6224596B1 (en) 1997-01-06 2001-05-01 Roger P. Jackson Set screw for use with osteosynthesis apparatus
FR2767675B1 (fr) 1997-08-26 1999-12-03 Materiel Orthopedique En Abreg Implant intersomatique et ancillaire de preparation adapte pour permettre sa pose
AU759236B2 (en) 1998-04-29 2003-04-10 Stryker Spine Backbone osteosynthesis system with clamping means in particular for anterior fixing
FR2784282B1 (fr) 1998-10-09 2001-03-23 Dimso Sa Systeme d'osteosynthese rachidienne a rigidite amelioree
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US6059786A (en) * 1998-10-22 2000-05-09 Jackson; Roger P. Set screw for medical implants
US6261288B1 (en) 2000-02-08 2001-07-17 Roger P. Jackson Implant stabilization and locking system
US6224598B1 (en) 2000-02-16 2001-05-01 Roger P. Jackson Bone screw threaded plug closure with central set screw
US7169183B2 (en) 2000-03-14 2007-01-30 Warsaw Orthopedic, Inc. Vertebral implant for promoting arthrodesis of the spine
US6251112B1 (en) 2000-04-18 2001-06-26 Roger P. Jackson Thin profile closure cap for open ended medical implant
US6379356B1 (en) 2000-04-26 2002-04-30 Roger P. Jackson Closure for open ended medical implant
US6258090B1 (en) 2000-04-28 2001-07-10 Roger P. Jackson Closure for open ended medical implant and removal tool
JP2001314416A (ja) * 2000-05-10 2001-11-13 Showa Ika Kohgyo Co Ltd 骨接合具用のロッド
US6440132B1 (en) 2000-05-24 2002-08-27 Roger P. Jackson Open head bone screw closure with threaded boss
US6884244B1 (en) 2000-06-06 2005-04-26 Roger P. Jackson Removable medical implant closure for open headed implants
US7833250B2 (en) 2004-11-10 2010-11-16 Jackson Roger P Polyaxial bone screw with helically wound capture connection
US6454768B1 (en) 2000-12-05 2002-09-24 Roger P. Jackson Removable gripping set screw
US6726687B2 (en) 2000-12-08 2004-04-27 Jackson Roger P Closure plug for open-headed medical implant
US6454772B1 (en) 2000-12-08 2002-09-24 Roger P. Jackson Set screw for medical implant with gripping side slots
US7862587B2 (en) 2004-02-27 2011-01-04 Jackson Roger P Dynamic stabilization assemblies, tool set and method
US10258382B2 (en) 2007-01-18 2019-04-16 Roger P. Jackson Rod-cord dynamic connection assemblies with slidable bone anchor attachment members along the cord
US10729469B2 (en) 2006-01-09 2020-08-04 Roger P. Jackson Flexible spinal stabilization assembly with spacer having off-axis core member
FR2835174B1 (fr) * 2002-01-31 2004-03-19 Materiel Orthopedique En Abreg Connecteur pour dispositif d'osteosynthese rachidienne, ensemble connecteur/organe d'ancrage osseux et dispositif d'osteosynthese rachidienne utilisant cet ensemble
FR2836370B1 (fr) * 2002-02-27 2005-02-04 Materiel Orthopedique En Abreg Plaque d'ancrage pour dispositif d'osteosynthese de la colonne vertebrale, et dispositif la comprenant
US6730089B2 (en) 2002-08-26 2004-05-04 Roger P. Jackson Nested closure plug and set screw with break-off heads
US8876868B2 (en) 2002-09-06 2014-11-04 Roger P. Jackson Helical guide and advancement flange with radially loaded lip
US7621918B2 (en) 2004-11-23 2009-11-24 Jackson Roger P Spinal fixation tool set and method
US7377923B2 (en) 2003-05-22 2008-05-27 Alphatec Spine, Inc. Variable angle spinal screw assembly
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Publication number Publication date
TW278029B (ko) 1996-06-11
DE69331525T2 (de) 2002-11-21
FR2697744A1 (fr) 1994-05-13
AU5601294A (en) 1994-06-08
EP0668749A1 (en) 1995-08-30
JP3615757B2 (ja) 2005-02-02
CA2149034A1 (en) 1994-05-26
NO951827L (no) 1995-06-23
JPH08505784A (ja) 1996-06-25
FI952227A0 (fi) 1995-05-09
FR2697744B1 (fr) 1995-03-03
NO951827D0 (no) 1995-05-09
KR950703897A (ko) 1995-11-17
ATE212528T1 (de) 2002-02-15
WO1994010927A1 (en) 1994-05-26
DE69331525D1 (de) 2002-03-14
EP0668749A4 (en) 1996-01-03

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